Provider Demographics
NPI:1831226612
Name:GOIFFON, JOANN CAROL (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:JOANN
Middle Name:CAROL
Last Name:GOIFFON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5265 E LAKE BEACH CT
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-1381
Mailing Address - Country:US
Mailing Address - Phone:651-483-0282
Mailing Address - Fax:
Practice Address - Street 1:500 OSBORNE RD NE
Practice Address - Street 2:UNITY PROFESSIONAL BUILDING SUITE 310
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-2765
Practice Address - Country:US
Practice Address - Phone:651-483-0282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5072235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1022810OtherPREFERRED ONE
MN129904OtherU-CARE
MN4600192OtherMEDICA
MN74512OtherHEALTH PARTNERS
MN4600192OtherSELECT CARE
MN1120004OtherMETROPOLITAN HEALTH PLANS
MN23086G0OtherBLUE CROSS-BLUE SHIELD